Study of Leucocyte Count, Serum Bilirubin and C-Reactive ProteinValues in Preoperative Diagnosis of Acute Appendicitis

Abstract

Acute appendicitis is one of the most common surgical emergencies all over the world. In appendicular perforation, morbidity and mortality increases significantly. A prompt diagnosis and early surgery can only be done if clinical findings are supported by laboratory tests.To estimate preoperative serum leukocyte count, total bilirubin and C-reactive protein levels in patients with clinical diagnosis of acute appendicitis and compare them with histopathological diagnosis postoperatively.Cross sectional study was conducted in Department of general surgery, NIMS medical college, Jaipur, during the period of September 2013 to August 2014. Patients were admitted with clinical diagnosis of acute appendicitis. Total 100 patients with clinical diagnosis of acute appendicitis were studied. Acute appendicitis was more in 2nd and 3rd decade of life with male to female ratio 3:2. TLC was increased more than 10000 in 73% patients, bilirubin was more than one in 82% patients and c- reactive protein was positive in 82% patients. Appendix was acutely inflamed in 76% patients on sonography and 76% on histopathology. 10 and 3% were perforated and gangrenous appendix. Only 6% were normal. Sensitivity and specificity of leukocyte count was 77.5 and 63.6%, C-reactive protein was 88.8 and 72.4% and serum bilirubin was 89.9 and 81.8% respectively.In addition to clinical and radiological examination, laboratory test are definitely helpful in diagnosing acute appendicitis. Serum bilirubin is more suitable parameter in diagnosing appendicitis than C-reactive protein and TLC.

Keywords: Total leukocyte count, serum bilirubin, C-reactive protein